1. Consumption of lichi fruit and skipping evening meal can result in very low blood glucose level and acute encephalopathy, seizures and coma, and causes death in many cases.
2. This is the cause of an unexplained illness in children aged 15 years and younger in Muzaffarpur, Bihar, which claimed many lives in May-June.
3. The results are published in journal Lancet Global Health.
4. Young children have limited hepatic glycogen reserves. Hypoglycin A and methylenecyclopropylglycine (MCPG) toxins, which are naturally present in litchi fruit block enzymes involved in normal glucose metabolism and this results in an inability to synthesis glucose leading to acutely low level of blood sugar.
5. Most of the children did not have fever and had normal CSF
6. Most sick children presented with low blood glucose levels
7. As per CDC there are reported cases of toxic hypoglycaemic syndrome in West Indies caused by hypoglycin A, a toxin found in ackee fruit, which is in the same family as litchi
8. MCPG, which is a homologue had been detected in the seed of litchis, and is reported to cause low blood glucose in rats.
9. Over 62% sick children had blood glucose level less than 70 mg/dL. The median was 48 mg/dL and it was as low as 8 mg/dL.
10. Researchers found metabolites of hypoglycin A and MCPG in 66% (48 of 73 cases) of urine samples but none from the 15 controls.
11. In 36 lichi samples tested, hypoglycin A ranged from 12.4-152 microgram per gram and MCPG ranged from 45-220 microgram per gram. The level of hypoglycin A and MCPG was twice in unripe compared with ripe fruits.
12. Dextrose therapy to children who were sick reduced mortality 44% in 2013 to 31% in 2014.
1. Minimising lichi consumption
2. Eating evening meal throughout the outbreak period
3. Implementing rapid glucose correction for suspected illness.
[Source~The Hindu&some News Agencies ]